Provider Demographics
NPI:1700842374
Name:DIPSONS INC
Entity Type:Organization
Organization Name:DIPSONS INC
Other - Org Name:CARE TEXAS HOME HEALTH HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIPEOLU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-789-8668
Mailing Address - Street 1:PO BOX 888
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0888
Mailing Address - Country:US
Mailing Address - Phone:713-789-8668
Mailing Address - Fax:713-780-4146
Practice Address - Street 1:11938 STROUD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2338
Practice Address - Country:US
Practice Address - Phone:713-789-8668
Practice Address - Fax:713-780-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-24
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007015251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177337601OtherTHSTEPS COMPREHENSIVECARE
TX48781OtherEVERCARE STAR PLUS
TX92931OtherAMERIGROUP
TX000065900Medicaid
TX000065900OtherLONG TERM CARE